Which payers have published criteria for Ultrasound imaging of the heart (CPT 93307)?

The imaging guidelines used by Aetna, Anthem BCBS, Cigna, UnitedHealthcare include criteria that apply to this study. Whether a specific patient's plan requires prior authorization depends on the plan, so confirm on the payer's portal or by phone before scheduling.

Who reviews prior authorization requests for Ultrasound imaging of the heart (CPT 93307)?

Most commercial payers hand imaging reviews to a radiology benefit manager. For the payers tracked here, requests are reviewed using guidelines from eviCore, Carelon, CMS, UnitedHealthcare / eviCore. The request is submitted through that organization's portal rather than the health plan's general line.

What should be in the clinical notes before requesting Ultrasound imaging of the heart (CPT 93307)?

Reviewers look for a recent office visit that documents the symptoms and how long they have lasted, exam findings, results of any earlier imaging, treatments already tried and how the patient responded, and the specific question the study is expected to answer. The diagnosis code on the request should match what the notes describe.

How much does Ultrasound imaging of the heart (CPT 93307) cost?

Across 831 hospitals that publish their negotiated rates, the median commercial insurance rate is $580, with the middle half of rates between $349 and $980. A patient's own cost depends on their plan, deductible and where the study is done.

What can be done if Ultrasound imaging of the heart (CPT 93307) is denied?

Read the denial letter for the stated reason, then request a peer-to-peer conversation between the ordering clinician and the reviewing physician, which often resolves missing-information denials. If that fails, file a written appeal that answers the stated reason directly and attach the supporting notes. The denial letter lists the deadline and where to send the appeal.

CPT 93307: Ultrasound imaging of the heart - Prior Authorization and Price

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CPT 93307

Ultrasound imaging of the heart.

Cardiac & Vascular Testing

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Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Cardiac Imaging Guidelines effective Feb 3, 2026 Abdomen Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Peripheral Vascular Disease (PVD) Imaging Guidelines 2.0.2026, effective Sep 1, 2026	13 that name this code
Anthem BCBS	Carelon	Imaging of the heart effective Nov 15, 2025	19 that name this code
Cigna	eviCore	Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Cardiac Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Abdomen Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Peripheral Vascular Disease (PVD) Imaging Guidelines 2.0.2026, effective Sep 1, 2026	13 that name this code
Medicare	CMS	—	None found
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare	UnitedHealthcare / eviCore	Commercial and Exchange Cardiovascular and Radiology Imaging Guidelines 09.2026, effective Sep 1, 2026	13 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss Ultrasound imaging of the heart. Each has its own criteria for when the study is considered appropriate.

Established bicuspid aortic valve Anthem BCBS
Established mitral valve prolapse Anthem BCBS
Established native valvular regurgitation Anthem BCBS
Established native valvular stenosis (does not apply to congenital valvular stenosis) Anthem BCBS
Established valvular heart disease – patients who have undergone valve intervention (replacement or repair) Anthem BCBS
Evaluation of aortic disease Anthem BCBS
Evaluation of cardiac masses or cardiac source of embolus Anthem BCBS
Evaluation of infective endocarditis (native or prosthetic valves) Anthem BCBS
Evaluation of patients with cardiac arrhythmias Anthem BCBS
Evaluation of patients with congenital heart disease Anthem BCBS
Evaluation of patients with known CAD Anthem BCBS
Evaluation of patients with pulmonary embolus Anthem BCBS
Evaluation of patients with pulmonary hypertension Anthem BCBS
Evaluation of patients with suspected CAD Anthem BCBS
Evaluation of pericardial diseases Anthem BCBS
Evaluation of signs, symptoms, or abnormal testing Anthem BCBS
Evaluation of suspected or established Kawasaki disease Anthem BCBS
Evaluation of ventricular function Anthem BCBS
Suspected valvular heart disease Anthem BCBS
Screening for Peripheral Artery /Aneurysmal Disease Aetna · Cigna · UnitedHealthcare
Transplant Aetna · Cigna · UnitedHealthcare
Hematopoietic Stem Cell Transplantation Aetna · Cigna · UnitedHealthcare
Long Term Pediatric Cancer Survivors Aetna · Cigna · UnitedHealthcare

Typical price

Commercial insurance, median

$580

Middle half of rates: $349 to $980

Medicare, hospital outpatient

$244

Facility payment

Medicare, physician fee schedule

$139

National, non-facility

Commercial figures come from negotiated rates published by 831 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for Ultrasound imaging of the heart change.

CPT 93307: Ultrasound imaging of the heart - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

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